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Prevention of healthcare-associated infections (HAIs) in a surgical urology ward: observational study—analysis of the problem and strategies for implementation

  • José Medina-PoloEmail author
  • Javier Gil-Moradillo
  • Juan Justo-Quintas
  • Daniel Antonio González-Padilla
  • Esther García-Rojo
  • Alejandro González-Díaz
  • Pablo Abad-López
  • Mario Hernández-Arroyo
  • Rocío Santos-Pérez de la Blanca
  • Helena Peña-Vallejo
  • Julio Téigell-Tobar
  • Francisco López-Medrano
  • Ángel Tejido-Sánchez
Topic Paper

Abstract

Purpose

Our purpose is to present the results of our working group, with a view to reduce the incidence and improve the management of healthcare-associated infections (HAIs) in a urology ward.

Methods

The study consists on an observational database designed with the view to analyse the incidence and characteristics of HAIs in Urology. Based on the results obtained, a critical evaluation was carried out and specific measures put in place to reduce HAIs. Finally, the impact and results of the implemented measures were periodically evaluated.

Results

The incidence of HAIs in urology decreased from 6.6 to 7.3% in 2012–2014 to 5.4–5.8% in 2016–2018. In patients with immunosuppression the incidence of HAIs decreased from 12.8 to 18% in 2012–2013 to 8.1–10.2% in 2017–2018, in those with a previous urinary infection fell from 13.6 to 4.8%, in those with a urinary catheter prior to admission from 12.6 to 10.8%, and in patients with a nephrostomy tube from 16 to 10.9%. The effect of the protocol also demonstrated a reduction in the percentage of patients with suspicion of HAIs for whom no culture was taken, from 6% in 2012 to zero in 2017 and 2018. Moreover, the implementation of protocols for empirical treatment has reduced the incidence of patients experiencing inadequate empirical antimicrobial therapy from 20 to 8.1%.

Conclusion

It is essential to monitor the incidence of HAIs, and preventive measures play a useful role in reducing the rate of infection and in optimising their management.

Keywords

Antibiotic resistance Healthcare-associated infection (HAI) Surgical site infection (SSI) Urinary tract infection (UTI) Urology Department 

Notes

Acknowledgements

We acknowledge the effort and collaboration to all personnel of the department of Urology for preventing infections. Moreover, special thanks for all the residents of our department who have actively collected and reviewed the data.

Author contributions

JM-P: project development, data collection or management, data analysis, and manuscript writing/editing. JG-M: data collection or management, data analysis, and manuscript writing/editing. JJ-Q: data collection or management, data analysis, and manuscript writing/editing. DAG-P: data collection or management, data analysis, and manuscript writing/editing. EG-R: data collection or management, data analysis, and manuscript writing/editing. AG-D: data collection or management, data analysis, and manuscript writing/editing. PA-L: data collection or management, and manuscript writing/editing. MH-A: data collection or management, and manuscript writing/editing. RS-PB: data collection or management manuscript writing/editing. HP-V: data collection or management and manuscript writing/editing. JT-T: data collection or management and manuscript writing/editing. FLM: data analysis and manuscript writing/editing. ÁT-S: project development, data analysis, and manuscript writing/editing.

Compliance with ethical standards

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

The prospective observational study did not affect the daily clinical practice. Therefore, additional informed consent was not required the patients included in the registry.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Urology and School of MedicineUniversidad Complutense Madrid, Hospital Universitario 12 de OctubreMadridSpain
  2. 2.Department of Infectious Diseases, School of MedicineUniversidad Complutense de Madrid and Health Research Institute i + 12, Hospital Universitario 12 de OctubreMadridSpain

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